Outcome of karydakis lateral flap versus open technique in the treatment of pilonidal sinus

Introduction: Pilonidal sinus disease is a chronic, recurrent disorder of the sacrococcygeal region, which commonly occurs in young adults following puberty. The male population is affected more frequently compared with the female population. A large number of surgical techniques (with varying complexity) have been described in the literature for the treatment of this disease. Such diversity suggests that no single technique has emerged as the preferred method in preventing recurrence of this condition. Objectives: The aim of this study was to compare karydakis lateral flap technique with open technique in the treatment of noncomplicated pilonidal sinus. Patients and methods: A total of 70 patients with uncomplicated pilonidal sinus, attending Minoufiya University Hospital and other private hospitals, were included in this study. They were divided into two groups: the karydakis group and the open procedure group. Results: A total of 57 male and 13 female patients were included in this study. The mean operative time in the karydakis and the open group was 45 ± 7.27 and 23.4 ± 4 min, respectively. There was a significantly lower rate of wound infection in the karydakis group. Two patients (5.7%) showed recurrence in the karydakis group, whereas eight patients (22.8%) had recurrence in the open group. There was no significant difference between the two groups as regards scar pain and numbness (P 0.05), but there was a significantly lower recurrence rate in the karydakis group (P = 0.022). The healing time and duration of work-off was significantly shorter in the karydakis group (P 0.001). Conclusion: Karydakis technique showed shorter hospital stay, earlier healing, shorter duration of work-off, and lower rate of complications compared with the open technique.